Over and over again, President Obama has expressed his commitment to the establishment of a government-run “public plan” as part of health reform, saying it is needed to keep the pressure on private insurance companies. Just as often, we have pointed out here that this kind of general statement can mean a lot of different things to different people. Today, we hear yet more evidence that the White House is quite flexible in how it views the whole idea of a public plan.
White House Chief of Staff tells the Wall Street Journal that it is far more important to create competition among private health insurers than to it is to establish a robust government-run option. And he sounds supportive of an idea being talked about by Republicans like Olympia Snowe, in which a public plan would be established only if private companies failed to step up to the plate. A similar “trigger” was included in the 2003 Medicare prescription drug plan, and has never been used:
Mr. Emanuel said one of several ways to meet President Barack Obama’s goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.
Mr. Obama has pushed hard for a vigorous public option. But he has also said he won’t draw a “line in the sand” over this point.
UPDATE: This is what is known as a “clarification”:
Statement from the President on Health Care Reform
“I am pleased by the progress we’re making on health care reform and still believe, as I’ve said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest. I look forward to a final product that achieves these very important goals.”
UPDATE2: Ezra Klein has an interesting point with respect to the precedent that Emanuel cites:
Putting aside the success, or lack thereof, of Medicare Part D, this is a bit of a weird comment. In 2003, Republicans controlled the White House, the House of Representatives, and the U.S. Senate. As such, when they tried to pass their legislation adding a private prescription drug benefit to Medicare, they allowed a small concession to Democrats: a weak public plan that would be activated if certain conditions weren’t met by private industry.
What Emanuel is saying here, however, is that in 2009, when Democrats control the White House, the House of Representatives, and the U.S. Senate — and have larger margins than Republicans ever did in the latter two — that they are interested in settling on the same policy compromise: a weak public plan that would be activated if certain conditions aren’t met by private industry. That’s a bit weird. Weren’t elections supposed to have consequences?
